Paranoia In The Elderly | Right At Home

Understanding Paranoia In The Elderly

For older adults, it is common to develop recurring worries, doubts, and grievances that sometimes strike their family members as unfounded, suspicious, nonsensical, or ridiculous. Caregivers may find it difficult to appease the worries or concerns of the elderly. Most families have concerns about an aging parent tracking back to underlying medical problems that should be identified and addressed. When it comes to paranoia, it is important to stay sensible about it and consult with a medical professional as soon as possible.

What Is Paranoia?

Paranoia is the sensation that maybe you're being threatened, like people watching you or plotting against you, even if there's no evidence that this is real. At some point, it happens to a lot of individuals. Even if you know that your worries are not based on fact, they can be disturbing if they arise too frequently.

More serious is clinical hysteria, an unusual mental health disorder. Without any proof, the person suffering from clinical hysteria concludes that others are unjust, dishonest, or deliberately attempting to harm them. 

Understanding the Differences

People with paranoia may be obsessed with getting other individuals to recognize their views as real. They can make unusual decisions that are intended to protect themselves from the causes of their anxiety.

Fleeting paranoia moments are widespread and do not necessarily indicate that a person has a mental health disorder. Paranoia is separate from fear. Here are some facts on paranoia:

  • Paranoia is based on a specific type of anxiety.
  • People who experience paranoia also have false assumptions that they know about themselves, the world, or people.
  • Perceptual problems can occur in an individual with paranoid thoughts. A 2008 study that linked social anxiety to paranoia found that paranoia was more likely to be reported by people with irregular perceptions, like hallucinations.
  • Paranoia, along with hallucinations and delusions, can be symptoms of an illness and are not a natural part of aging. Although they can appear similar, they are very different. Here are some of the differences between them:


Hallucinations, which may be visual, auditory, or tactile, are false sensory perceptions. It is not possible to correct these assumptions by telling a patient that they are just not real. Examples involve hearing music when no one is playing or seeing bugs or people that are not there.


Delusions are false perceptions and are also triggered by defective memory. Examples include accusing family or caregivers of theft or treason. 


Suspiciousness is the main characteristic of paranoia. Older adults also project aggression and anger by paranoid actions on caregivers.

Possible Reasons For Paranoia

A variety of health conditions may lead to irrational anxiety, paranoid behavior, or constant fear. Here are some of the reasons:

Alzheimer's disease

Alzheimer's is a chronic condition where, over the years, signs of dementia gradually intensify. Memory loss is mild in its early stages, but with late-stage Alzheimer's, people lose the ability to continue a conversation and adapt to their surroundings.

Tumors of the brain

The accumulation—or a mass— of abnormal cells in the brain is a brain tumor. Any growth can cause problems within such a limited space. Tumors may be cancerous (malignant) or noncancerous (benign).

Certain medications 

Some medications may be harmful to seniors with paranoia, such as methamphetamine, amphetamine, ketamine, and of course, the consumption of alcohol and drugs. 


Dementia, in general terms, includes memory loss, loss of vocabulary, problem-solving, and other lack of cognitive skills that are too extreme, so they interfere with everyday life. Also, the most common cause of dementia is Alzheimer's disease.

Urinary tract infections left untreated

The primary danger associated with untreated UTIs is that they can spread to one or both kidneys from the bladder. UTIs can cause damage that will permanently decrease kidney function as bacteria invade the kidneys.

Vascular damage

Any disorder that impacts the network of blood vessels is considered vascular damage. Examples of vascular damage include diseases such as peripheral artery disease (PAD), abdominal aortic aneurysm (AAA), carotid artery disease (CAD), and chronic venous insufficiency (CVI). 

As a family member, if you are concerned about your loved one's health, you need to talk to a doctor. If your elderly parent is on Medicare and shows signs of paranoia, tests could be free at a geriatric evaluation facility—depending on the state you live in.

Examples of Paranoia in the Elderly

Here are some examples of paranoia in the elderly:

  • They think that people talk about them behind their back. In this case, a doctor should check their hearing first to ensure that there is no problem in that area.
  • They swear that they see people who aren't anywhere near them. In this situation, to alleviate their anxiety, their doctor may prescribe them a tranquilizing drug.
  • They become paranoid about their finances. The elder's family will want to layout their loved one's financial image and have a trusted advisor provide them with information.
  • They believe their family doesn't love them anymore, as they do not visit when they think they should. The family must stay calm in this situation and be patient while explaining the reality of things.

Symptoms of Paranoia

Can paranoia be a symptom of dementia? While paranoid behavior is a symptom of a medical condition in many instances, the senior's family might be concerned about the possibility of dementia. In the case of paranoia, a paranoid elderly may automatically think anyone is stealing cash—when the money has just been misplaced—or that the neighbor is taking the newspaper. Before the family dismisses paranoia or dementia, some symptoms require a comprehensive investigation by considering certain paranoid activities. 

In addition to the above examples, other everyday worries, concerns, and grievances of a paranoid older adult—which may seem unreasonable to caregivers— include: 

  • They feel like they're being persecuted unfairly.
  • They hear unusual sounds (even if it’s an innocent noise, like a tree branch scratching a window, for instance).
  • They see people or animals that are not there (possibly a vision problem or a side effect of medication).
  • They are 100% sure people speak behind their backs.

Responding to Paranoia in the Elderly

How can you help someone with paranoia? Paranoia is less prevalent than hallucinations and delusions, yet it may still be quite disturbing. As paranoia occurs, caregivers should analyze the issue and formulate solutions by considering the next questions:

  • What happened just before the senior became suspicious?
  • Has such a thing happened before?
  • Was this in the same room, or was it at the same hour of the day?

Tips For Caregivers

  •  To be patient and understanding.
  • Avoid neglecting minor changes in actions since these may imply a larger problem over time.
  • Reassuring and validating your loved one's feelings is more important than attempting to offer logical explanations. 
  • Journaling regular habits so that you can look for indicators of progress or abrupt regression.
  • Carefully monitor the actions of the senior and potential causes of this behavior.
  • Keeping a record of the activities of the older adult.
  • To remember that paranoia cases are, in their majority, treatable. 
  • Seek medical advice
  • Trying to figure out what is the trigger or origin of your loved one’s feelings.

Are you caring for a family member or an elder experiencing extreme anxiety, paranoia, or unfounded worry? Contact Right At Home and ask for our caregivers' services so we can lend you a hand. We can also offer advice on how to help you and your family deal with a relative who’s experiencing paranoia. Right At Home is a reliable and trustworthy company that specializes in improving your loved one's quality of life. Call today!

Bruce Gropper
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